In a time where the World Health Organization’s 65 year old definition of health is put into question and health care moves toward shifting the focus on illness to promoting wellness, the Affordable Care Act (ACA) is expected to help push the car in that direction. So, does the new health law include coverage for complementary and alternative medicine (CAM) such as chiropractic, acupuncture and herbal treatments?
Yes, in principle.
ACA is said to have the intention to expand any approaches that promote health and wellness in the community. However, at closer look the only wellness and preventive items that would be clearly covered under the health law would be standard screenings and immunizations with a mention to “healthy aging, living well and evaluation of community-based prevention and wellness programs for Medicare beneficiaries.”
Media has told us that this is the first time in U.S. history that complementary and alternative medicine, as well as integrative medicine practitioners, have been “included” in a federal health care law. End of the sugar-coated story.
President Obama’s hurdles with health care reform don’t end with last year’s favorable ruling by the Supreme Court in favor of the law and not even with his reelection.
Evidence-based vs. complementary and alternative medicine
The Affordable Care Act mentions complementary and alternative medicine and integrative health care a total of seven times.
One section specifically prohibits insurance companies from discriminating against alternative health care providers.
So, in theory, insurance companies under ACA would reimburse “doctors of chiropractic, licensed complementary and alternative medicine practitioners,” and this would reduce health costs.
However, how to overcome the strong and organized opposition from the traditional medical establishment?
For years, underfunded research has kept complementary and alternative medicine marginal to the so-called “evidence-based” practices. However, people seek CAM practitioners in ever-increasing numbers. It’s been a catch-22 situation.
People who argue in favor of “evidence-based” medicine have defied the introduction of any complementary and alternative medicine in the mandated “essential health benefits (EHBs)” packages.
But alternative practitioners’ hopes are based on the fact that the EHBs items and services listed include “rehabilitative and habilitative services” and “preventive and wellness services.” However, the Institute of Medicine (IOM) has issued recommendations that are allegedly aimed at “eliminating pseudoscience” from insurance coverage.
According to the IOM, “only medically necessary services should be covered,” and the EHB package “needs to be based on credible evidence of effectiveness.”
It’s understandable that insurance leans toward low risk, well-proven, effective medical care.
Validity of for profit funded research
However, complementary and alternative medicine practitioners and its defenders also have doubts about the validity of clinical trials that promote medication-based medicine, wondering how valid evidence born from Big Pharma’s for-profit funding can be.
Giving a closer look to the reliance of evidence-based “science,” you’d find, for example, that after reviewing 370 clinical trials in 2003 to determine any bias in drug company-sponsored research, the Journal of the American Medical Association concluded that industry-sponsored studies were significantly more likely to reach conclusions that were favorable to the sponsor than were non-industry studies.